Dale W Blaise, MD in Murphysboro, IL - Medicare Family Medicine

Dale W Blaise, MD is a medicare enrolled "Family Medicine" physician in Murphysboro, Illinois. His current practice location is 19 E Shawnee Dr Ste 2, Murphysboro, Illinois. You can reach out to his office (for appointments etc.) via phone at (618) 684-2172.

Dale W Blaise is licensed to practice in Illinois (license number 036065426) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1770557472.

Contact Information

	Dale W Blaise, MD
	19 E Shawnee Dr Ste 2, Murphysboro, IL 62966-7072
	(618) 684-2172
	(618) 687-4480

Map and Direction

Physician's Profile

Full Name	Dale W Blaise
Gender	Male
Speciality	Family Medicine
Location	19 E Shawnee Dr Ste 2, Murphysboro, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1770557472
Provider Enumeration Date: 02/17/2006
Last Update Date: 08/24/2022

Medicare PECOS Information:

PECOS PAC ID: 0941106660
Enrollment ID: I20070329000493

Medical Identifiers

Medical identifiers for Dale W Blaise such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1770557472	NPI	-	NPPES
036065426	Medicaid	IL
7210895	Other	IL	AETNA
3932056	Other	IL	BCBS
8630880	Other	IL	MULTI PLAN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	036065426 (Illinois)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dale W Blaise allows following entities to bill medicare on his behalf.

Entity Name	Southern Illinois Hospital Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1528158573 PECOS PAC ID: 2961310966 Enrollment ID: O20031211000718

Entity Name	Southern Illinois Medical Services Nfp
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1770656837 PECOS PAC ID: 3678677390 Enrollment ID: O20070404000595

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dale W Blaise is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dale W Blaise, MD Po Box 3988, Carbondale, IL 62902-3988 Ph: (618) 457-5200	Dale W Blaise, MD 19 E Shawnee Dr Ste 2, Murphysboro, IL 62966-7072 Ph: (618) 684-2172

Reviews and Comments

Family Medicine Doctors in Murphysboro, IL

Emily D Hanson, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 19 E Shawnee Dr Ste 2, Murphysboro, IL 62966 Phone: 618-684-2172 Fax: 618-687-4480
Dr. Kowsika Movva, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7 S Hospital Dr, Murphysboro, IL 62966 Phone: 618-519-9200 Fax: 618-684-2748
Jeffrey Ripperda, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7 South Hospital Drive, Murphysboro, IL 62966 Phone: 618-687-3418 Fax: 618-687-1859
Mr. Evan Tep Belfer, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 801 N 14th St, Murphysboro, IL 62966 Phone: 618-687-2319 Fax: 618-684-3321
Todd Smith, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 7 South Hospital Drive, Murphysboro, IL 62966 Phone: 618-687-3418 Fax: 618-687-1859
Clare T Williams, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7 S Hospital Dr, Murphysboro, IL 62966 Phone: 618-687-3418 Fax: 618-687-1859

Dale W Blaise, MD - Medicare Family Medicine in Murphysboro, IL